Lameness & Non- Surgical Therapies of the Equine Athlete
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1 Lameness & Non- Surgical Therapies of the Equine Athlete Mark T. Reilly, DVM, Dipl. ABVP (Equine) Linda J. Cimetti, DVM South Shore Equine Clinic & Diagnostic Center
2 Lameness & Non-Surgical Therapy of the Equine Athlete South Shore Equine Clinic & Diagnostic Center 151 Palmer Road Plympton, MA (781)
3
4 Lameness Degenerative Acute/Traumatic Infectious
5 Lameness Genetic/Developmental Hematogenous Iatrogenic
6 Lameness Diagnosis Exam/Evaluate Diagnostic Anesthesia Diagnostic Imaging
7 Physical Exam Heat Swelling Pain Bone Exostosis (Splints) History Discipline Lameness
8 Lameness Evaluation Under Saddle In Hand Hard surface Deep sand Direction Flexion
9 Lameness Diagnostic Anesthesia Regional Intra-articular **Localization of lameness allows targeted therapy
10 Lameness - Imaging Diagnostic Imaging Radiographs Ultrasound Scintigraphy MRI
11 Lameness- Imaging Radiographs Bone abnormalities Joint surfaces Arthritis Fractures OCD lesions
12 Lameness - Imaging Radiographs Bone abnormalities Joint surfaces Arthritis Fractures OCD lesions
13 Lameness - Imaging Radiographs Bone abnormalities Joint surfaces Arthritis Fractures OCD lesions
14 Lameness - Imaging Radiographs Bone abnormalities Joint surfaces Arthritis Fractures OCD lesions
15 Lameness - Imaging Ultrasound Soft Tissue Tendons, ligaments Cartilage Joint Surfaces Menisci (Stifle)
16 Lameness - Imaging Ultrasound Soft Tissue Tendons, ligaments Cartilage Joint Surfaces Menisci (Stifle)
17 Lameness - Imaging Nuclear Scintigraphy Detects early OA Stress subchondral bone changes
18 Lameness - Imaging Nuclear Scintigraphy Sensitive screening Tool Not a specific anatomical problem
19 Lameness - Imaging MRI Bone Soft tissue Cartilage Abnormal fluid content ** Allows visualization of structures in the hoof
20 Lameness - Imaging MRI Bone Soft tissue Cartilage Abnormal fluid content ** Allows visualization of structures in the hoof
21 Lameness - Imaging MRI Identify lesions not visible on radiographs Cysts Bone edema or hemorrhage Fractures
22 Lameness - Imaging MRI Identify lesions unable to be visualized with ultrasound in foot DDFT Impar Ligament Collat. Sesamoidean Ligament of Nav. Bone Collateral Ligaments
23 Lameness - Imaging MRI Limited ability to scan above fetlock in standing horse Cooperative Height Anesthetized
24
25 Lameness Physical Exam Evaluation Diagnostic Anesthesia Diagnostic Imaging Treatment General Targeted Controlled Rehabilitation
26 Lameness Corrective Shoeing
27 Lameness Joint Supplements Chondroiten Sulfate Glucosamine MSM PSGAGs Ascorbic Acid Hyaluronic Acid
28 Lameness Shoeing 4-6 weeks Therapeutic Prophylactic (Pads) Discipline
29 Lameness Muscle Supplements Omega 3 Fatty Acids High Fat (PSSM) Creatine MSM Organozynol (Gamma Grow)
30 Lameness Hoof Supplements Methionine Biotin Zinc
31 Lameness Physical Exam Evaluation Diagnostic Anesthesia Diagnostic Imaging Treatment General Targeted Controlled Rehabilitation
32 Lameness 4 R s Repair damage healing phase Regain Motion walk before run Rebuild Strength gradual increases Return to Work sound and healthy
33 Targeted Therapy Joints/ Intra-articular Extra-articular Soft Tissue Lameness
34 Targeted Therapy Lameness Do you know what you are treating? Do you know what to treat with?
35 Targeted Therapy Joints/ Intra-articular Extra-articular Soft Tissue Lameness
36 Lameness Targeted Intra-Articular Therapy What are we treating?
37 Lameness
38 Lameness
39 Lameness Arthritis Degenerative Traumatic Constant turnover of cartilage matrix & healthy joint fluid
40 Lameness Arthritis Intra-articular joint injections Corticosteroids (Triamcinolone, depo medrol) Hyaluronic Acid (Hylartin-V) Antibiotic (Amikacin)
41 Lameness Therapeutics Local Joint Injections Which joints? With what?
42 Lameness Therapeutics Local Joint Injections Which joints? With what? Example - hock
43 Targeted Therapy Joints/ Intra-articular Extra-articular Soft Tissue Lameness
44 Targeted Therapy Joints/ Intra-articular Extra-articular Soft Tissue Lameness
45 Lameness Arthritis/Peri-articular Tissues Autologous Serum (IRAP) IL-1 Antagonist 24 hour incubation Early DJD Multiple txs $$$
46 Lameness Arthritis/Peri-articular Tissues Stem Cell injection Fat, Bone Marrow Procure, Isolate & Concentrate 48 hour turnaround Inject $$$
47 Targeted Therapy Joints/ Intra-articular Extra-articular Soft Tissue Lameness
48 Soft Tissue ECSWT PRP Stem Cell Lameness
49 Soft Tissue ECSWT Lameness 3-5 treatments 7-14 days apart Joints, Back, Ringbone
50 Soft Tissue ECSWT Lameness Angiogenesis Analgesia $$($)
51 Soft Tissue PRP (Platelet Rich Plasma) -Autologous -14 minute preparation Lameness
52 Soft Tissue PRP (Platelet Rich Plasma) -Same day plus frozen aliquots -$$ Lameness
53 Soft Tissue Stem Cell Fat cells: 1/50 Bone Marrow: 1/100,000 Lameness
54 Soft Tissue Stem Cell Harvested and concentrated Ultrasound guided injection Lameness
55 Soft Tissue PRP Stem Cell Combined therapy Best outcome? $$$$ Lameness
56 Care of the Equine Athlete Veterinary Care / Maintenance
57 Lameness - General Dentistry Annual to semi-annual exam/float
58 Care of the Equine Athlete Performance Dentistry Floating the teeth to maximize the performance of that horse both in mastication and when ridden (differentiate from the practice of simple removal of sharp points)
59 Care of the Equine Athlete Veterinary Care / Maintenance Therapeutics Systemic Local
60 Care of the Equine Athlete Therapeutics Systemic - Joint Treatments PSGAG s Hyaluronic Acid * Injectable glucosamine Adequan
61 Care of the Equine Athlete Therapeutics Systemic - NSAIDs Bute Banamine Ketofen Robaxin
62 Care of the Equine Athlete Therapeutics Local Systemic Topical
63 Care of the Equine Athlete Athletic Training TOPICAL TREATMENTS
64 Care of the Equine Athlete Athletic Training TOPICAL TREATMENTS
65 Care of the Equine Athlete Athletic Training TOPICAL TREATMENTS
66 Care of the Equine Athlete
67 Care of the Equine Athlete Therapeutics Systemic Local Alternative Chiropractic Acupuncture Mesotherapy
68 Care of the Equine Athlete Therapeutics Alternative Systemic Local
69 Care of the Equine Athlete Prognostics Historical Follow Up
70 Care of the Equine Athlete Athletic Training WALK
71 Care of the Equine Athlete Athletic Training TROT
72 Care of the Equine Athlete Athletic Training CANTER
73 Care of the Equine Athlete Athletic Training CANTER
74 Care of the Equine Athlete Follow Up 30 day re-evaluation Ultrasound Palpation 2-3 month re-check Evaluate rehabilitation Increase/Decrease workload Must balance between too much stress and enough stress to stimulate tissue response.
75 Care of the Equine Athlete Prognostics Adherence to Rehabilitation Plan is imperative for treatment success!!
76 Care of the Equine Athlete
77 Care of the Equine Athlete Questions? Comments?
78 REMINDER Upcoming Client Education Seminars will start up again in the fall!! Have a great season!
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